| NPI | 1306004247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 83021) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036126470) |
| 207Q00000X Family Medicine (Licence: WI 100158) | |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2025-05-05 |